Five things you should know about long-term health insurance

Who is going to live to 100 anyway? Maybe you. Statistics Canada said there were 5,825 centenarians in 2011 and the number will grow to 78,300 by 2061 — one of the highest growth rates of any population group in the country.

In Toronto, a woman we’ll call Veronica, 50, has built her financial life on hard work and independence.

She brings home $2,660 a month as a self-employed media consultant, keeps up her small house on a tree-shaded street, maintains financial records diligently, but worries that when she wants to retire, she won’t have the means to make it work.
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The Canadian Life and Health Insurance Association says over the next 35 years as Baby Boomers grow older, the bill for providing for them will be about $1.2-trillion and government will only cover half that tab.

A poll conducted by Leger Marketing, albeit sponsored by the insurance industry, found 67% of Canadians have no plan to cover the ongoing costs of long-term care. Here are five things you should know:

What is long-term care insurance? It provides you coverage if you can’t care for yourself because of chronic illness, disability or cognitive impairment. Coverage can include stays in nursing homes, chronic care facilities or bringing a caregiver into your home.

What type of plan do you want? Do you want one that reimburses you for eligible expenses such as private nursing or one that offers a monthly predetermined stipend? With the income plan, you could even spend the money to have someone from your own family look after you one day. Don’t forget most plans have a 30-90 day waiting period before they kick in.

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What does the government really cover? The Canadian Life and Health Insurance Association says the cost of a private room in a retirement residence, not covered by any government subsidy, could run you anywhere from $850 a month to $6,700. Home-care easily costs you $35 per hour and skilled nursing rates are up to $85 per hour in some provinces. The Association says paying for that higher standard of care could cost you anywhere from $35,000 to $65,000 annually.

Why apply now for long-term insurance if you’re not even close to being a senior? The younger you are the cheaper your premium will be. The state of your health will also be important in determining your rate so if you can sign up before you have any outstanding medical conditions it could save you money. The more coverage you get, the more you will pay. A longer waiting period before benefits kick in can also lower your premiums like a high deductible on auto insurance.

How goes long-term care insurance pay out? It comes down to whether you can still perform everyday tasks. Usually the the test is whether you cannot perform two of them without substantial help. The tasks considered are bathing, dressing, toileting, transferring (which includes something like getting from a bed to a chair), maintaining continence and eating.